Features of the course of community-acquired pneumonia in children before and during the COVID-19 pandemic

Abstract

Introduction. The basis of the work was a retrospective analysis of the course of community-acquired pneumonia (CAP) in children with COVID-19. Aim. To determine the features of the course of CAP before and during the COVID-19 pandemic in children from birth to 18 years. Materials and methods. A retrospective analysis of the medical records of ninety five children (n = 95) who were treated at the Speransky Children’s Hospital No. 9 before the pandemic (October-November 2019; n = 45) and during the COVID-19 pandemic (April-May 2020 and October-November 2020; n = 50). All the received data are processed statistically. Results. It was found that before the COVID-19 pandemic, mainly adolescents aged 13-17 years were ill, during the pandemic younger children (6-12 years old) became ill more often. With the onset of the pandemic, the course of CAP changed significantly: fever, cough, shortness of breath were typical clinical signs; local signs were more pronounced in children during the pandemic: weakened and hard breathing was more often detected. Leukocytosis and accelerated ESR prevailed in patients with CAP before the pandemic. At the same time, CRP was a more sensitive marker of inflammation. It was revealed that with the beginning of the COVID-19 pandemic, the number of atypical pneumonia decreased, which may be due to anti-epidemic measures, but the prevalence of pneumonia of unknown etiology increased. Decreased oxygen saturation was a more frequent rule in CAP during the pandemic. Lobar pneumonia prevailed in children before the pandemic, and polysegmental pneumonia prevailed in patients during the pandemic. Conclusion. The features presented by the authors of the manifestations of community-acquired pneumonia in children before and during the COVID-19 pandemic make it possible to optimize their diagnosis using clinical and laboratory signs.